The ATRIA Score

NOTE: Whilst we have done our utmost to ensure the accuracy of the data in this section, users should access the original publications. This will also allow you to see how the algorithm was created, the population studied and any limitations to the study.

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1. The Hazard ratios for age [and hence the scores] are different if the patient has had a previous stroke] and these are engineered into the algorithm

2. All patients should undergo a bleeding risk evaluation before commencing anticoagulation. A number of such algorithms exist for establishing this - click HERE to access these algorithms.

1. Singer DE, Chang Y, et al. A new risk scheme to predict ischemic stroke and other thromboembolism in atrial fibrillation: the ATRIA study stroke risk score. J Am Heart Assoc. 2013; 2: e000250.

2. Go AS, Fang MC, et al. Impact of proteinuria and glomerular filtration rate on risk of thromboembolism in atrial fibrillation: the anticoagulation and risk factors in atrial fibrillation (ATRIA) study. Circulation. 2009; 119: 1363-9.

3. Aspberg S, Chang Y, et al. Comparison of the ATRIA, CHADS₂, and CHA₂DS₂-VASc stroke risk scores in predicting ischaemic stroke in a large Swedish cohort of patients with atrial fibrillation. European Heart Journal. 2016; 37: 3203-10.

4. van den Ham HA, Klungel OH, et al. Comparative Performance of ATRIA, CHADS₂, and CHA₂DS₂-VASc Risk Scores Predicting Stroke in Patients With Atrial Fibrillation: Results From a National Primary Care Database. Journal of the American College of Cardiology. 2015; 66: 1851-9.

5. Consider a PUBMED search to explore other key references in this area.

6. Click HERE to access the NICE guidelines on Atrial Fibrillation.

Previous Stroke
	Yes
	No
Age [Note: The Hazard ratios for age [and hence the scores] are different if the patient has had a previous stroke]
	<65 years	8 points if previous stroke 0 points if no history of stroke
	65-74 years	7 points if previous stroke 3 points if no history of stroke
	75-84 years	7 points if previous stroke 5 points if no history of stroke
	≥85 years	9 points if previous stroke 6 points if no history of stroke
Female
	Yes	1 Point
	No	0 Points
Diabetes Mellitus
	Yes	1 Point
	No	0 Points
Chronic Heart Failure
	Yes	1 Point
	No	0 Points
Hypertension
	Yes	1 Point
	No	0 Points
Proteinuria
	Yes	1 Point
	No	0 Points
eGFR <45mL/min or End Stage Renal Disease [ESRD]
	Yes	1 Point
	No	0 Points

Interpretation
0 - 5 points	Low Risk: Annual risk of recurrence 0.65%
6 points	Moderate Risk: Annual risk of recurrence 1.91%
7 - 15 points	High Risk: Annual risk of recurrence 3.89%

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